Search results for: rural medicine

Authors: Nkeiruka Elsie Ezomike, Chinwe L. Onyekonwu, Anthony N. Ikefuna, Bede C. Ibe

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Superficial fungal infections (SFIs) are one of the common cutaneous infections that affect children worldwide. They may lead to school absenteeism or school drop-out and hence setback in the education of the child. Community-based studies in any locality are good reflections of the health conditions within that area. There is a dearth of information in the literature about SFI among primary school children in Enugu. This study aimed to determine the clinicomycological pattern of SFIs among primary school children in rural and urban communities in Enugu. This was a comparative descriptive cross-sectional study among primary school children in Awgu (rural) and Enugu North (urban) Local Government Areas (LGAs). Subjects' selection was made over 6 months using a multi-stage sampling method. Information such as age, sex, parental education, and occupation were collected using questionnaires. Socioeconomic classes of the children were determined using the classification proposed by Oyedeji et al. The samples were collected from subjects with SFIs. Potassium hydroxide tests were done on the samples. The samples that tested positive were cultured for SFI by inoculating onto Sabouraud's dextrose chloramphenicol actidione agar. The characteristics of the isolates were identified according to their morphological features using Mycology Online, Atlas 2000, and Mycology Review 2003. Equal numbers of children were recruited from the two LGAs. A total of 1662 pupils were studied. The mean ages of the study subjects were 9.03 ± 2.10years in rural and 10.46 ± 2.33years in urban communities. The male to female ratio was 1.6:1 in rural and 1:1.1 in urban communities. The personal hygiene of the children was significantly related to the presence of SFIs. The overall prevalence of SFIs among the study participants was 45%. In the rural, the prevalence was 29.6%, and in the urban prevalence was 60.4%. The types of SFIs were tinea capitis (the commonest), tinea corporis, pityriasis Versicolor, tinea unguium, and tinea manuum with prevalence rates lower in rural than urban communities. The clinical patterns were gray patch and black dot type of non-inflammatory tinea capitis, kerion, tinea corporis with trunk and limb distributions, and pityriasis Versicolor with face, trunk and limb distributions. Gray patch was the most frequent pattern of SFI seen in rural and urban communities. Black dot type was more frequent in rural than urban communities. SFIs were frequent among children aged 5 to 8years in rural and 9 to 12 years in urban communities. SFIs were commoner in males in the rural, whereas female dominance was observed in the urban. SFIs were more in children from low social class and those with poor hygiene. Trichophyton tonsurans and Trichophyton soudanese were the common mycological isolates in rural and urban communities, respectively. In conclusion, SFIs were less prevalent in rural than in urban communities. Trichophyton species were the most common fungal isolates in the communities. Health education of mothers and their children on SFI and good personal hygiene will reduce the incidence of SFIs.

Keywords: clinicomycological pattern, communities, primary school children, superficial fungal infections

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Authors: Mohammad Mirwais Arghandiwal, Fujita Motohiro, Wisinee Wisetjindawat

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Since 2001, the new government of Afghanistan addressed the improvement of transportation in rural areas as one of the key issues for the country development. This paper thus, aims to show the impotency of transportation in the rural area of Kabul province. A field survey in Kabul Province capital of Afghanistan has been conducted during March, 2015, and 201 questionnaires were collected from four districts named Shakar Dara, Paghman, Char Asyab, and Khak Jabar to investigate the impacts of road transportation on the people’s daily life. The districts had their road projects constructed during the last 3-5 years. The interviewees are chosen randomly from a different category of districts residences. As transportation is one of the most important factors for the development of the communities, during the survey it was very easily to observe a positive effect on the life of people. The improvement on the accessibility has had a positive impact on the land and land price. In this paper, a model is created to show the relationship between different factors and the land price improvement. In the end, a recommendation is presented on the establishment of the community council for a better use and maintenance of road projects. We emphasize on a public and private partnership at a community level in the districts during the construction period too. In addition, the communities should be encouraged on their positive role in the improvement of transportation through their participation and collaboration with the local government.

Keywords: accessibility, Afghanistan, poverty, rural area, transportation development

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Authors: Sidiqat A. Aderinoye-Abdulwahab, Lateef L. Adefalu, Rashid S. Adisa, Felix O. Oladipo, Tawakalitu A. Dolapo

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This study investigates whether the rural women in Nigeria have access to productive resources such as land, livestock, and capital in order to determine their level of socio-economic empowerment. The study adopted a case study design while employing qualitative and quantitative methods of data collection. A multi-stage sampling technique was used to identify 7 locations, where 88 women were selected based on simple random sampling technique. Focus group discussions and questionnaire were used to elicit information. Gender analysis framework was used to explore and analyse the data generated for the study. The study found that the rural women desire to engage in gainful economic activities. However, cultural barriers prevent them from adequately exploring livelihood-improving opportunities. It was established that ownership of productive resources such as land and livestock can enhance their livelihoods provided cultural and governance issues do not deter them from accessing the services. It was therefore recommended that appropriate policies that will favour the access and ownership of assets by women so as to empower them need to be in place. The study provides a nuanced perspective on the influence and relevance of possession of physical assets in enhancing women’s livelihood diversification and overall development of rural livelihoods.

Keywords: livelihoods, productivity, development, economic activities, socio-economic empowerment

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Authors: Jeremy Schultz

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The purpose of this study was to understand the perceptions of vineyard managers in the Krasnodar Region of Southern Russia located between the city of Kransnodar and the Black Sea. In recent years, wine tourism throughout the region has seen tremendous growth due in part to the concurrent growth in the number of tourists vacationing at the Black Sea. This trend has contributed to the development of large-scale wine operations developing in numerous rural locations along the tourists’ travel path. Niche areas of tourism, such as wine tourism, have proven to provide economic viability for rural communities all around the world. Understanding their shared group characteristics while honoring their unique qualities as individuals aids in responsible wine tourism development that provides a sense of well-being for the communities and stakeholders involved. Semi-structured interviews and lived experience methodologies were used in locations that were associated with wine food tourism operations. By understanding management perspectives, it lends insight into sustainable destination management and wine tourism product development, furthering our progress toward ethical, responsible, and financially feasible operations. This research also represents a collaborative effort between Russia and the United States that supports an agenda of sustainable destination development and management. As a global community, we need to continue to investigate stakeholder perceptions and strategic management techniques that best support the pillars upon which responsible tourism was founded.

Keywords: wine tourism, tourism development, Russia, rural tourism

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Authors: Abubakar Ahmed, Zainab Mohammed, Hadiza D. Nuhu, Hamisu Ibrahim

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Introduction: The plant Tacazzea apiculata Oliv (Periplocaceae) is widely distributed in tropical West Africa. It is claimed to have multiple uses in traditional medicine among which are its use to treat hemorrhoids, inflammations and cancers. Methods: Ethno-botanical survey through interview and using show-and-tell method of data collection were conducted among Hausa and Fulani tribes of northern Nigeria with the view to document useful information on the numerous claims by the local people on the plant. Results: The results revealed that the plant T. apiculata has relative popularity among the herbalist (38.2 %), nomads (14.8 %) and fishermen (16.0%). The most important uses of the plant in traditional medicine are inflammation (Fedelity level: 25.7 %) and Haemorrhoids (Fedelity level: 17.1 %) Conclusion: These results suggest the relevance of T. apiculata in traditional medicine and as a good candidate for drug Development.

Keywords: ethno-botany, periplocaceae, Tacazzea apiculata, traditional medicine

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Authors: Emma Pope, Demos Parapanos

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Rural tourism has become more obvious and prevalent, with tourists’ increasingly seeking authentic experiences. This movement accelerated post-Covid, putting destinations in danger of reaching levels of saturation called ‘overtourism’. Whereas the phenomenon of overtourism has been frequently discussed in the urban context by academics and practitioners over recent years, it has hardly been referred to in the context of rural tourism, where perhaps it is even more difficult to manage. Rural tourism was historically considered small-scale, marked by its traditional character and by having little impact on nature and rural society. The increasing number of rural areas experiencing overtourism, however, demonstrates the need for new approaches, especially as the impacts and enablers of overtourism are context specific. Cumbria, with approximately 47 million visitors each year, and 23,000 operational enterprises, is one of these rural areas experiencing overtourism in the UK. Using the county of Cumbria as an example, this paper aims to explore better planning and management in rural destinations by clustering the area into rural and ‘urban-rural’ tourism zones. To achieve the aim, this study uses secondary data from a variety of sources to identify variables relating to visitor economy development and demand. These data include census data relating to population and employment, tourism industry-specific data including tourism revenue, visitor activities, and accommodation stock, and big data sources such as Trip Advisor and All Trails. The combination of these data sources provides a breadth of tourism-related variables. The subsequent analysis of this data draws upon various validated models. For example, tourism and hospitality employment density, territorial tourism pressure, and accommodation density. In addition to these statistical calculations, other data are utilized to further understand the context of these zones, for example, tourist services, attractions, and activities. The data was imported into ARCGIS where the density of the different variables is visualized on maps. This study aims to provide an understanding of the geographical context of visitor economy development and tourist behavior in rural areas. The findings contribute to an understanding of the spatial dynamics of tourism within the region of Cumbria through the creation of thematized maps. Different zones of tourism industry clusters are identified, which include elements relating to attractions, enterprises, infrastructure, tourism employment and economic impact. These maps visualize hot and cold spots relating to a variety of tourism contexts. It is believed that the strategy used to provide a visual overview of tourism development and demand in Cumbria could provide a strategic tool for rural areas to better plan marketing opportunities and avoid overtourism. These findings can inform future sustainability policy and destination management strategies within the areas through an understanding of the processes behind the emergence of both hot and cold spots. It may mean that attract and disperse needs to be reviewed in terms of a strategic option. In other words, to use sector or zonal policies for the individual hot or cold areas with transitional zones dependent upon local economic, social and environmental factors.

Keywords: overtourism, rural tourism, sustainable tourism, tourism planning, tourism zones

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Authors: Bailey Hall, Athena Hoppe, Tevyn Kagele, Anna Nichols, Breeanna Messner

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The Spokane Street Medicine (SSM) Program aims to deliver medical care to people experiencing homelessness in Spokane, Washington. Street medicine is designed to function in a non-traditional setting to help deliver healthcare to a largely underserved population. In this analysis, the SSM Program’s medical charts from street and shelter encounters in early 2021 were reviewed in order to identify illness and diseases in people experiencing homelessness in Spokane. More than half of the prescriptions written during these encounters were for either an antibacterial, an antibiotic, or an antifungal. Estimates of the cost to the local healthcare system are included. Initiating treatment for communicable diseases in people experiencing homelessness via street medicine efforts greatly reduces economic costs while improving health outcomes.

Keywords: ethical issues in public health, equity issues in public health, health economics, health disparities, healthcare costs, medical public health, public health ethics, street medicine

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Authors: L. V. S. S. Phaneendra Bolem, S. Shankar

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Low Volume Rural Roads (LVRRs) constitute an integral component of the road system in all countries. These encompass all aspects of the social and economic development of rural communities. It is known that on a worldwide basis the number of low traffic roads far exceeds the length of high volume roads. Across India, 90% of the roads are LVRRs, and they often form the most important link in terms of providing access to educational, medical, recreational and commercial activities in local and regional areas. In the recent past, Government of India (GoI), with the initiation of the ambitious programme namely 'Pradhan Mantri Gram Sadak Yojana' (PMGSY) gave greater importance to LVRRs realizing their role in economic development of rural communities. The vast expansion of the road network has brought connectivity to the rural areas of the country. Further, it is noticed that due to increasing axle loads and lack of timely maintenance, is accelerated the process of deterioration of LVRRs. In addition to this due to limited budget for maintenance of these roads systematic and scientific approach in utilizing the available resources has been necessitated. This would enable better prioritization and ranking for the maintenance and make ‘all-weather roads’. Taking this into account the present study has adopted a multi-criteria approach. The multi-criteria approach includes parameters such as social, economic, environmental and pavement condition as the main criterion and some sub-criteria to find the best suitable parameters and their weight. For this purpose the expert’s opinion survey was carried out using Delphi Technique (DT) considering Likert scale, pairwise comparison and ranking methods and entire data was analyzed. Finally, this study developed the maintenance criterion considering the socio-economic, environmental and pavement condition parameters for effective maintenance of low volume roads based on the engineering judgment.

Keywords: Delphi technique, experts opinion survey, low volume rural road maintenance, multi criteria analysis

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Authors: J. O. Ayinde, S. O. Olatunji

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This study assessed rural youth adoption of cassava production technologies in Southwestern, Nigeria. Specifically, it examine the level of awareness and adoption of cassava production technologies by rural youth, determined the extent of usage of cassava production technologies available to the rural youth, examined constrains to the adoption of cassava production technologies by youth and suggested possible solutions. Multistage sampling procedure was adopted for the study. In the first stage, two states were purposively selected in southwest, Nigeria which are Osun and Oyo states due to high level of cassava production and access to cassava production technology in the areas. In the second stage, purposive sampling technique was used to select two local governments each from the states selected which are Ibarapa central (Igbo-Ora) and Ibarapa East (Eruwa) Local Government Areas (LGAs) in Oyo state; and Ife North (Ipetumodu) and Ede South (Oke Ireesi) LGAs in Osun State. In the third stage, proportionate sampling technique was used to randomly select five, four, six and four communities from the selected LGAs respectively representing 20 percent of the rural communities in them, in all 19 communities were selected. In the fourth stage, Snow ball sampling technique was used to select about 7 rural youths in each community selected to make a total of 133 respondents. Validated structured interview schedule was used to elicit information from the respondents. The data collected were analyzed using both descriptive and inferential statistics to summarize and test the hypotheses of the study. The results show that the average age of rural youths participating in cassava production in the study area is 29 ± 2.6 years and 60 percent aged between 30 and 35 years. Also, more male (67.4 %) were involved in cassava production than females (32.6 %). The result also reveals that the average size of farm land of the respondents is 2.5 ± 0.3 hectares. Also, more male (67.4 %) were involved in cassava production than females (32.6 %). Also, extent of usage of the technologies (r = 0.363, p ≤ 0.01) shows significant relationship with level of adoption of the technologies. Household size (b = 0.183; P ≤ 0.01) and membership of social organizations were significant at 0.01 (b = 0.331; P ≤ 0.01) while age was significant at 0.10 (b = 0.097; P ≤ 0.05). On the other hand 0.01, years of residence (b = - 0.063; P ≤ 0.01) and income (b = - 0.204; P ≤ 0.01) had negative values and implies that a unit increase in each of these variables would decrease extent of usage of the Cassava production technologies. It was concluded that the extent of usage of the technologies in the communities will affect the rate of adoption positively and this will change the negative perception of youths on cassava production thereby ensure food security in the study area.

Keywords: assessment, rural youths’, Cassava production technologies, agricultural production, food security

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Authors: Martha Karunakar

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There exists a wide divide between the urban and the rural students in a vast country like India. This dichotomy is seen in the resources available to them, like the learning facilities, the infra-structure, the learning ambience and meeting of their basic needs of food, clothing and shelter. This paper discusses the effect of English language teaching as a Bridge course on a select batch of rural students at an Engineering college in Chennai, one of the four Metros of India. The study aims to understand how the teacher input and the teacher- peer-student interaction facilitates the acquisition of the basic structures of the English language to a group that is minimally exposed to the language. The objective in conducting the Bridge Course is to integrate these rural students into the mainstream and empower them in terms of English speaking ability; to enable them to comprehend their respective engineering classes where the medium of instruction is English and also to be able to interact with their urban peers. This program is conducted prior to the start of a regular academic session to equip them face the rigors of engineering education. The study is placed within the framework of Interaction theory in second language acquisition. The study evaluates the impact of linking theory and practice by implementing meaningful interaction not only within classrooms but also in the common areas. By providing intensive comprehensible input, it is anticipated that participant’s level of English language improves. The teaching methods and classroom activities included individual and group participation, encompassing all the four skills of listening, speaking, reading and writing (LSRW). The diagnostic tests that were administered before the commencement of the course and the exit test after the completion were used to record the impact of the training.

Keywords: comprehensible input, interaction, rural students, teaching English

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Authors: D. K. Sreekantha, T. M. Girish, R. H. Fattepur

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In this article, we have given an overview of medical expert systems, which can be used for the developed of physicians in making decisions such as appropriate, prognostic, and therapeutic decisions which help to organize, store, and gives appropriate medical knowledge needed by physicians and practitioners during medical operations or further treatment. If they support the studies by using these systems, advanced tools in medicine will be developed in the future. New trends in the methodology of development of medical expert systems have also been discussed in this paper. So Authors would like to develop an innovative IT based solution to help doctors in rural areas to gain expertise in Medical Science for treating patients. This paper aims to survey the Soft Computing techniques in treating patient’s problems used throughout the world.

Keywords: expert system, fuzzy logic, knowledge base, soft computing, epilepsy

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Authors: Clemens Pizzinini, Philipp Rosner, David Ziegler, Markus Lienkamp

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Transportation is a constitutional part of most supply and value chains in modern economies. Smallholder farmers in rural Ethiopia face severe challenges along their supply and value chains. In particular, suitable, affordable, and available transport services are in high demand. To develop a context-specific technical solutions, a problem-to-solution methodology based on the interaction with technology is developed. With this approach, we fill the gap between proven transportation assessment frameworks and general user-centered techniques. Central to our approach is an electric test vehicle that is implemented in rural supply and value chains for research, development, and testing. Based on our objective and the derived methodological requirements, a set of existing methods is selected. Local partners are integrated into an organizational framework that executes major parts of this research endeavour in the Arsi Zone, Oromia Region, Ethiopia.

Keywords: agricultural value chain, participatory methods, agile methods, sub-Saharan Africa, Ethiopia, electric vehicle, transport service

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Authors: Martin Mundo-Molina

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In Mexico, there are many small rural communities with serious water supply deficiencies. In Chiapas, Mexico, there are 19,972 poor rural communities, 15,712 of which have fewer than 100 inhabitants. The lack of a constant water supply is most severe in the highlands of Chiapas where the population is made up mainly of indigenous groups. The communities are on mountainous terrain with a widely dispersed population. These characteristics combine to make the provision of public utilities, such as water, electricity and sewerage, difficult with conventional means. The introduction of alternative, low-cost technologies represents means of supplying water such as through fog and rain catchment with zero greenhouse emissions. In this paper is presented the rainwater harvesting system (RWS) constructed in Yalentay, Chiapas Mexico. The RWS is able to store 1.2 M liters of water to provide drinking water to small rural indigenous communities of 500 people in the drought stage. Inside the system of rainwater harvesting there isn't photosynthesis in order to conserve water for long periods. The natural filters of the system of rainwater harvesting guarantee the drinking water for using to the community. The combination of potability and low cost makes rain collection a viable alternative for rural areas, weather permitting. The Mexican Institute of Water Technology and Chiapas University constructed a rainwater harvesting system in Yalentay Chiapas, it consists of four parts: 1. Roof of aluminum, for collecting rainwater, 2. Underground-cistern, divided in two tanks, 3. Filters, to improve the water quality and 4. The system of rainwater harvesting dignified the lives of people in Yalentay, saves energy, prevents the emission of greenhouse gases into the atmosphere, conserves natural resources such as water and air.

Keywords: appropriate technologies, climate change, greenhouse gases, rainwater harvesting

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Authors: Jeana Cadby, Kae Miyazawa

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With rapidly expanding worldwide adoption of mobile technologies, Information and Communication Technology (ITC) is a major energy user and a contributor to global carbon emissions, due to infrastructure and operational energy consumption. The agricultural sector is also significantly responsible for contributing to global carbon emissions. However, ICT cloud computing using mobile technology can directly reduce environmental impacts in the agricultural sector through applications and mobile connectivity, such as precision fertilizer and pesticide applications, or access to weather data, for example. While direct impacts are easily calculated, indirect environmental impacts from ICT cloud computing usage have not been thoroughly investigated. For example, while women may be more poorly equipped for adaptation to environmentally sustainable agricultural practices due to resource constraints, this research concludes that indirect environmental benefits can be achieved by improving rural access to mobile technology for women. Women in advanced roles and secure land tenure are more likely to invest in long-term agricultural conservation strategies, which protect against environmental degradation. This study examines how ICT using mobile technology advances the role of women in rural agricultural systems and indirectly reduces environmental impacts from agricultural production, through literature examination from secondary sources. Increasing access for women to ICT mobile technology provides indirect environmental and social benefits in the rural agricultural sector.

Keywords: cloud computing, environmental benefits, mobile technology, women

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Authors: Meirav Eshkol, Miri Blaufeld, Rinat Basal

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Aim: The working environment in rural clinics is often isolated and distant from major health centers. In these circumstances, rural health care faces numerous challenges. The hope is that, in the immediate future and in the medium and long range, the rural nursing staff will realize their full professional and personal potential to their own satisfaction and to the health and welfare of their patients. Background: Rural nurses work mostly alone or with very few colleagues, and have the authority to make professional decisions, a fact which often requires them to make critical decisions in pressure situations. In addition, the expectations set for these nurses are extremely high, a fact which requires them to be extremely skilled and to fulfill their professional potential. They are required to provide high-quality and comprehensive care to the individual, the family, and the community and to maintain close interaction with the community. Work in a rural setting requires the flexibility to perform multiple tasks in an isolated setting, often far removed from major health centers. In order to maintain professional satisfaction for the rural nurse, expanded direction and training are required in professional know-how, and in the development of new and existing skills, toward the goal of treating a diverse population and to obtain a comprehensive view of the components of a diagnosis for treatment and to develop an understanding appropriate to the presented reality. Objective: To provide knowledge and to expand and develop professional skills in the prevention and advancement of health in the care of a diverse patient population. The development of strategies and skills for work under pressure alone instills expertise in performing multiple tasks in diverse disciplines. To reduce feelings of stress and burnout. Methodology: This course is the first and one of a kind in Clalit - the biggest health organisation in Israel. Observing and identifying the needs of the nurses in the field relating to the development of professional and personal skills defining goals and objectives, and determining the content of a course designed for rural nurses and kibbutz nurses who are not Clalit employees. Results: 43 nurses participated and 30 answered the feedback questionnaire. The rating of their experience was 4.33 (on a scale of 1-5, with 5 being the highest ranking). 92% indicated the importance of meeting with additional nurses to teach their colleagues. 83% of the nurses indicated an increased sense of organizational belonging. 60% indicated that the course helped to reduce feelings of stress and burnout in becoming a better rural nurse. 80% indicated that the course helped them establish intra-organizational professional cooperation and initiating processes. Conclusion: The course is an instrument which aids in increasing the feeling of organizational belonging, reducing feelings of stress and burnout, creation of relationships and cooperation both within and outside of the organization, increased the realization of the potential of the village nurse.

Keywords: rural nurse, alone, burnout, multiple tasks

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Authors: Kenneth Nhundu, Leocadia Zhou, Farhad Aghdasi, Voster Muchenje

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Climate change poses increased risks to rural communities that rely on natural resources, such as forests, cropland and rangeland, waterways, and open spaces Because of their connection to the land and the potential for climate change to impact natural resources and disrupt ecosystems and seasons, rural livelihoods and well-being are disproportionately vulnerable to climate change. Climate change has the potential to affect the environment in a number of ways that place increased stress on everyone, but disproportionately on the most vulnerable populations, including the young, the old, those with chronic illness, and the poor. The communities in the study area are predominantly rural, resource-based and are generally surrounded by public or private lands that are dominated by natural resources, including forests, rangelands, and agriculture. The livelihoods of these communities are tied to natural resources. Therefore, targeted strategies to cope will be required. This paper assessed the household socio-economic characteristics and their implications to household vulnerability to climate change impacts in the rural Eastern Cape Province, South Africa. The results indicate that the rural communities are climate-vulnerable populations as they have a large proportion of people who are less economically or physically capable of adapting to climate change. The study therefore recommends that at each level, the needs, knowledge, and voices of vulnerable populations, including indigenous peoples and resource-based communities, deserve consideration and incorporation so that climate change policy (1) ensures that all people are supported and able to act, (2) provides as robust a strategy as possible to address a rapidly changing environment, and (3) enhances equity and justice.

Keywords: climate change, vulnerable, socio-economic, livelihoods

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Authors: Dilay Merve Temur

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How knowledge is produced and how scientific knowledge progress are questions that science philosophers have investigated for centuries. When the scientific and technological developments reached the 20th century, Kuhn proposed a completely new view among all the approaches. In this article, firstly, Kuhn's theory is represented. Secondly, the criticisms of Kuhn's theory directed to him are examined, and Galison's proposal for the trade area term of the incommensurability thesis is shared. The interaction of Humoral Theory with nutrition has been illustrated extensively, and the transition to modern medicine has been described historically by including scientific and technological developments in the field of medicine. This paper will seek to see how the concept of nutrition is positioned as a trading zone within the medicine paradigm, which has experienced a revolution within the framework of the paradigm concept introduced by Kuhn.

Keywords: food studies, incommensurability, nutrition and dietetics, trading zone

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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Authors: Inayatullah Jan, Sidra Pervez

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Effective institutional arrangements at local and national levels are quintessential for promotion of renewable energy in a country. This study attempts to examine the institutional arrangements for development of domestic renewable energy in rural northwest Pakistan. The study describes that very limited number of public and private organizations were working on clean development in the area. Surprisingly, no institutional arrangements exclusively meant for domestic clean energy promotion were observed in the area. The study concludes that the objectives of Kyoto Protocol in Pakistan can be achieved only if the government and non-governmental organizations work together to launch cost-effective renewable energy interventions, particularly in rural areas. The need is to have a coordinated, consistent, and focused cooperation of all stakeholders involved in promotion of domestic renewable energy at all levels. This will not only improve the socioeconomic and environmental conditions in the local context, but will play a key role in achieving the United Nations Millennium Development Goals(MDGs).

Keywords: governance, clean energy, greenhouse gases, CDM, Northwest Pakistan

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Authors: N. Amruth Raj, Suja S. Nair

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The last six decades have borne witness to a radical change in the private sectors relationship with both the state and civil society. Firms have been increasingly called upon to adopt strategies beyond the financial aspects of their operations and consider the social and environmental impact of their business activities. In this context, many companies have modified their policies and activities and engaged into Corporate Social Responsibility (CSR) especially on Rural development in India. At the firm level, CSR is implemented through various practices, which aim to enhance the company’s social and environmental performance and may cover various topics. Examples of CSR practices are abundant in Andhra Pradesh relevant literature. For instance, in India especially at Andhra Pradesh companies like Amara Raaja requires from its suppliers to prohibit child labour, Nagarjuna Cements applies a series of programs for reducing its CO2 emissions, LANCO group of Industries addresses health and safety issues in the workplace whereas GVK works limited has adopted a series of policies for addressing human rights and environmental abuse related to its operations.

Keywords: CSR, limitations, need, objectives, rural development

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Authors: S. Sambath, P. Palanivel

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Research conducted in the last few decades has proven that an inclusion of Distributed Genaration (DG) into distribution systems considerably lowers the level of power losses and the power quality improved. Moreover, the choice of DG is even more attractive since it provides not only benefits in power loss minimisation, but also a wide range of other advantages including environment, economic, power qualities and technical issues. This paper is an intent to quantify and analyse the impact of distributed generation (DG) in Tamil Nadu, India to examine what the benefits of decentralized generation would be for meeting rural loads. We used load flow analysis to simulate and quantify the loss reduction and power quality enhancement by having decentralized generation available line conditions for actual rural feeders in Tamil Nadu, India. Reactive and voltage profile was considered. This helps utilities to better plan their system in rural areas to meet dispersed loads, while optimizing the renewable and decentralised generation sources.

Keywords: distributed generation, distribution system, load flow analysis, optimal location, power quality

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Authors: Xiaoli Tian

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The recent growing interest in and use of complementary and alternative medicine is a global phenomenon. In many regions, traditional Chinese medicine (TCM), an important type of complementary and alternative medicine, has been formally integrated into the healthcare system. Consequently, today’s doctors face increasing requests and questions from patients regarding TCM. However, studies of TCM focus either on patients’ approaches to TCM and Western medicine (WM) or on the politics involved in the institutionalization of TCM. To our knowledge, sociological studies on doctors’ attitudes toward TCM are rare. This paper compares the receptivity of WM-trained Chinese doctors to TCM in Hong Kong and mainland China, in order to evaluate the interplay between professional training and dominant medical paradigms, on the one hand, and institutional legitimacy and government and client pressures to accept TCM, on the other. Based on survey and in-depth interviews with Western-medicine doctors in Hong Kong and mainland China, this research finds that: there is major difference between Western-medicine doctors’ attitude toward traditional Chinese medicine (TCM) in Hong Kong and mainland China. Doctors in Hong Kong are still suspicious toward TCM, no matter if they have exposure to TCM or not. Even some doctors who have much knowledge about TCM, such as got a diploma or certificate in TCM or tried TCM themselves, are still suspicious. This is because they hold up to the ideal of 'evidence-based medicine' and emphasize the kind of evidence based on randomized controlled trial (RCT). To Western medicine doctors in Hong Kong, this is the most reliable type of evidence for any medical practice, but it is lacking in TCM. This is the major reason why they do not trust TCM and would not refer patients to TCM in clinical practices. In contrast, western medicine doctors in mainland China also know about randomized controlled trial (RCT) and believe that’s the most reliable evidence, but they tend to think experience-based evidence is also reliable. On this basis, they think TCM also has clinical effectiveness. Research findings reveal that legitimacy based on institutional arrangements is a relevant factor, but how doctors understand their professional boundaries also play an important role. Doctors in Hong Kong are more serious about a strict professional boundary between Western medicine and TCM because they benefited from it, such as a very prestigious status and high income. Doctors in mainland China tend to be flexible about professional boundaries because they never benefited from a well-defined strict professional boundary. This is related to a long history of the lack of professionalism in China but is also aggravated by the increasing state support of TCM.

Keywords: evidence-based decision-making, institutional legitimacy, professional behavior, traditional Chinese medicine

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Authors: Bahago I. N., Oyewole O. E.

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Nigeria has the second highest prevalence of intestinal worms globally, which has not declined since the 1970s, especially in rural communities. Identifying the gaps in self-care practice will pave a way for a suitable intervention. This study investigated the knowledge, perception, and practice of deworming among mothers of under-five children in rural communities of Lafia Local Government Area, Nasarawa State. This study was descriptive cross-sectional and involved 419 mothers selected by systematic sampling technique. Information was obtained using a valid interviewer-questionnaire. Knowledge, perception, and practice was measured using a 10-point scale for each variable, respectively. Scores of 0-4, >4-6, and >6 were categorised as poor, average/fair, and good, respectively, at p<0.05 level of significance. Respondents’ age was 30.3±9.2 years; 46.5% were into trading, 26.7% were unemployed, 9.3% were skilled labour, and 7.4% were farmers. On literacy, secondary school (25.5%) while 9.1% above secondary school. Many (51.1%) had 2-3 children, while 42.2% had 5 or more children. Most of the respondents (96.2%) had good knowledge of deworming, and 3.8% had fair knowledge. Using multivariate model, Mothers between the ages of 25-34 years were 20 times likely to be more knowledgeable, given they have access to health information (O.R 2.39 -164.31). Most (62.3%) had good perception scores, 33.2% had fair scores, while 4.5% had poor perception scores. Majority (66.4%) had a good deworming practice of deworming, 66.4% had good, 28.4% had fair, and 5.3% had poor practice. The test of association between Parent's literacy level, religion, and age were significantly associated with the level of knowledge of deworming. Knowledge of deworming was above average; perception and practice was good. Women of ages 25-34 years could be trained as community volunteers to propagate the right information about deworming in rural communities, especially among young women of ages 13-19 years. Preferred channels to obtaining health information identified in the study should be explored.

Keywords: deworming, mothers of under-five, intestinal worms, rural communities

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Authors: Arsalan Jabbar, Wajiha Javed, Nelofer Mehboob, Zahid Memon

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Introduction: There are multiple social, individual and cultural factors that influence an individual’s decision to adopt family planning methods especially among non-users in patriarchal societies like Pakistan.Non-users, if targeted efficiently, can contribute significantly to country’s CPR. A research study showed that non-users if convinced to adopt lactational amenorrhea method can shift to long-term methods in future. Research shows that if non-users are targeted efficiently a 59% reduction in unintended pregnancies in Saharan Africa and South-Central and South-East Asia is anticipated. Methods: We did secondary data analysis on Pakistan Demographic Heath Survey (2012-13) dataset. Use of contraception (never-use/ever-use) was the outcome variable. At univariate level Chi-square/Fisher Exact test was used to assess relationship of baseline covariates with contraception use. Then variables to be incorporated in the model were checked for multi-collinearity, confounding, and interaction. Then binary logistic regression (with an urban-rural stratification) was done to find the relationship between contraception use and baseline demographic and social variables. Results: The multivariate analyses of the study showed that younger women (≤ 29 years) were more prone to be never users as compared to those who were > 30 years and this trend was seen in urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR 1.809, CI 1.421-2.303). While looking at regional variation, women from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as compared to other urban regions. Women in the rich wealth quintile were more never users and this was seen both in urban and rural localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162, CI .887-1.524)) even though these were not statistically significant. Women idealizing more children(> 4) are more never users as compared to those idealizing less children in both urban (AOR 1.854, CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916). Women who never lost a pregnancy were more inclined to be non-users in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar with only traditional or no method had more never users in rural areas (AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant. Women unaware of Lady Health Worker’s presence in their area were more never users especially in rural areas (AOR 1.276, CI 1.014-1.607). Women who did not visit any care provider were more never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR 7.832, CI 6.243-9.826)). Discussion/Conclusion: This study concluded that government, policy makers and private sector family planning programs should focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more children.). We need to make sure to cover catchment areas where there are less LHWs and less providers as ignorance to modern methods and never been visited by an LHW are important determinants of never use. This all is in sync with previous literate from similar developing countries.

Keywords: contraception, demographic and health survey, family planning, never users

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Authors: Arfan Riasat, M. Iqbal Zafar, Gulfam Riasat

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Pakistani women actively participate in livestock management activities, along with their normal domestic chores. The study was designed to measure the position and contribution of rural women, their constraints in livestock management activities and mainly how the rural women contribute for development in the district Faisalabad. It was envisioned that women participation in livestock activities have rarely been investigated. A multistage random sampling technique was used to collect the data from Tehsil Summandry of the district selected at random. Two union councils were taken by using simple random sampling technique. Four Chak (village) from each union council were selected at random and fifteen woman were further selected randomly from each selected chak. The results show that a vast majority of women were illiterate, having annual family income of one to two lac. They are living in joint family system. Their main occupation is agriculture and they spend long hours in whole livestock related activities to support their families. A large proportion of the respondents reported that they had to face problems and constraints in livestock activities in the context of decision making, medication, awareness, training along with social and economic issues. Analysis indicated that education level of women, income of household, age were significantly associated with level of participation. Women participation in livestock activities increased production and they were involved in income generating activities for better economic conditions of their families.

Keywords: women, participation, livestock, management, rural development

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Authors: Abiola O. Temitayo-Oboh, Olugbenga L. Abodunrin, Wasiu O. Adebimpe, Micheal C. Asuzu

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Introduction: Many women who are sexually active would prefer to avoid becoming pregnant but are not using any method of contraception. These women are considered to have an unmet need for contraception. In an ideal situation, all women who want to space or limit their births and are exposed to the risk of conception would use some kind of conception; in practice, however, some women fail to use contraception which put them at risk of having mistimed or unwanted births, induced abortion, or maternal death. This study, therefore, aimed to assess the determinants of unmet need for contraception among currently married women in rural and urban communities of Osun State, South-West Nigeria. Methods: This was an analytical cross-sectional comparative study, which was carried out among currently married women. Three hundred and twenty respondents each were selected for the rural and urban groups from four Local Government Areas using multi-stage sampling technique. Data were collected using a pre-tested semi-structured interviewer-administered questionnaire and focus group discussion (FGD) guide; data analysis was done with Statistical Package for Social Sciences (SPSS) version 17.0 and detailed content analysis method respectively. Statistical analysis of the difference between proportions was done by the use of the Chi-square test and T-test was used to compare the means of the continuous variables. The study also utilized descriptive, bivariate and multivariate analytical techniques to examine the effect of some variables on unmet need. Level of statistical significance was set at p-value < 0.05 for all values. Results: Two hundred and ninety-six (92.5%) of the rural and 306 (95.6%) of the urban study population had heard of contraception, 365 (57.0 %) of the total respondents had good knowledge [162 (50.6 %) for rural respondents and 203 (63.4 %) for urban respondents]. This difference was statistically significant (p < 0.001). Five hundred and twenty-one (81.4%) respondents had a positive attitude towards contraception [243 (75.9%) in the rural and 278 (86.9%) in the urban area], and the difference was also statistically significant (p < 0.001). Only 47 (14.7%) and 59 (18.4%) of rural and urban women were current contraceptive users respectively. The total unmet need for contraception among rural women was 138 (43.1%) of which 82 (25.6%) was for spacing and 56 (17.5%), for limiting. While the total unmet need for contraception among urban women was 145 (45.3%) of which 96 (30.0%) was for spacing and 49 (15.3%) for limiting. Number of living children, knowledge of contraceptive methods, discussion with health workers about family planning, couples discussion about family planning and availability of family planning services were found to be predictors of women’s unmet need for contraception (p < 0.05). Conclusion: It is, therefore, recommended that there is need to intensify reproductive health education in bridging the knowledge gap, improving attitude and modifying practices regarding use of contraception in Nigeria. Hence, this will help to enhance the utilization of family planning services among Nigerian women.

Keywords: contraception, married women, Nigeria, rural, urban, unmet need

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Authors: Kaycee Bills

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This study examined the mobility experiences faced by female older adults who have physical disabilities and require the use of wheelchairs or other equipment for mobility. Despite the advances in ADA policies that were put in place to accommodate those who have disabilities, the findings of this study suggest that women who are older adults with disabilities face mobility issues in rural regions regarding the steepness of ramps, narrow spaces, and rough terrain on a regular basis), which require additional assistance. Implications for future practice and research are discussed.

Keywords: social work, accessibility, disability, gender equality

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Authors: Yan Wang; Mathis Stock

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The World Heritage Site of Honghe Hani rice terrace, also a marginal rural region in Southern China, is undergoing rapid change because of urbanization and heritage tourism. Influenced by out-migration and changing ways of living in the urbanization process, the place sees a tendency of losing its rice terrace landscape, traditional housings and other forms of cultural traditions. However, heritage tourism tends to keep the past, valorize them for tourism purposes and diversifies rural livelihood strategies. The place stands at this development trajectories, where the same resources are subjected to different uses by different actors. The research seeks to answer the questions of how the site is transformed and co-constructed by different institutions, practices and actors, and the how heritage tourism affects local livelihood. The research aims to describe the transformation of villages, rice terraces, and cultural traditions, analyze the place-making process, and assess the role of heritage tourism in local livelihood transition. The research uses a mixed of methods including direct observation, participant observation, interviews; collects various data of images, words, narratives, and statistics, and analyze them qualitatively and qualitatively. Theoretically, it is hoped that the research would reexamine the concept of heritage, the world heritage practice from UNESCO, reveal the conflicts it entails in development and brings more thoughts from a functional perspective on heritage in relation to rural development. Practically, it is also anticipated that the research could access the linkage between heritage tourism and local livelihood, and generate concrete suggestions on how tourism could engage locals and improve their livelihood.

Keywords: cultural landscape, Hani rice terraces, heritage tourism, livelihood strategy, place making, rural development, transformation

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Authors: Mohua Dutta

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The primary aim of this research paper is to investigate the forced urban migration of Dalits in India who are fleeing caste persecution in rural areas. This paper examines the relationship between caste and rural-to-urban internal migration in India using a literary text, Rohinton Mistry’s A Fine Balance, highlighting the challenges faced by Dalits in rural areas that force them to migrate to urban areas. Despite the prevalence of such discussions in Dalit autobiographies written in vernacular languages, there is a lack of discussion regarding caste migration in Indian English Literature, including this present text, as evidenced by the existing critical interpretations of the novel, which this paper seeks to rectify. The primary research question is how urban migration affects caste system in India and why rural-to-urban caste migration occurs. The purpose of this paper is to better understand the reasons for Dalit migration, the challenges they face in rural and urban areas, and the lingering influence of caste in both rural and urban areas. The study reveals that the promise of mobility and emancipation provided by class operations drives rural-to-urban caste migration in India, but it also reveals that caste marginalization in rural areas is closely linked to class marginalization and other forms of subalternity in urban areas. Moreover, the caste system persists in urban areas as well, making Dalit migrants more vulnerable to social, political, and economic discrimination. The reason for this is that, despite changes in profession and urban migration, the trapped structure of caste capital and family networks exposes migrants to caste and class oppressions. To reach its conclusion, this study employs a variety of methodologies. Discourse analysis is used to investigate the current debates and narratives surrounding caste migration. Critical race theory, specifically intersectional theory and social constructivism, aids in comprehending the complexities of caste, class, and migration. Mistry's novel is subjected to textual analysis in order to identify and interpret references to caste migration. Secondary data, such as theoretical understanding of the caste system in operation and scholarly works on caste migration, are also used to support and strengthen the findings and arguments presented in the paper. The study concludes that rural-to-urban caste migration in India is primarily motivated by the promise of socioeconomic mobility and emancipation offered by urban spaces. However, the caste system persists in urban areas, resulting in the continued marginalisation and discrimination of Dalit migrants. The study also highlights the limitations of urban migration in providing true emancipation for Dalit migrants, as they remain trapped within caste and family network structures. Overall, the study raises awareness of the complexities surrounding caste migration and its impact on the lives of India's marginalised communities. This study contributes to the field of Migration Studies by shedding light on an often-overlooked issue: Dalit migration. It challenges existing literary critical interpretations by emphasising the significance of caste migration in Indian English Literature. The study also emphasises the interconnectedness of caste and class, broadening understanding of how these systems function in both rural and urban areas.

Keywords: rural-to-urban caste migration in india, internal migration in india, caste system in india, dalit movement in india, rooster coop of caste and class, urban poor as subalterns

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Authors: S. Ibrahim, Bashir Umar

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Agricultural credit is very important for sustainable agricultural development to be achieved in any country of the world. Rural credit has proven to be a powerful instrument against poverty reduction and development in rural area. Agricultural credit enhances productivity and promotes standard of living by breaking vicious cycle of poverty of small scale farmers. This study examined access to credit among rural farmers in Giwa local government area of Kaduna state. Two stages sampling procedure was employed to select forty-two (42) respondents for the study. Primary data were collected using structured questionnaire with the help of well-trained enumerators. Data were analyzed using simple descriptive statistics. The results revealed that farmers were predominantly male (57.1%) and most (54.7%), were married with one level of education or another (66.5.%). Majority of the households’ head were between the ages of 31 to 50. majority of the farmers (68.2%) had more than 2ha of farmlands with at least 5 years of farming experience and an annual farm income of N 61,000 to 100,000 (61.9%). The Various sources of credit by the farmers in the study area were commercial banks (38.1%), Co-operative banks (47.6%), Development banks (14.2%) (formal) and Relatives (26.1%), Personal Savings (Adashi scheme) (52.3%), Moneylenders (21.4%) (informal). As regard to the amount of credit obtained by the farmers 38.1% received N 50,000-100,000, 50 % obtained N 100,001-500,000 while 11.9% obtained N 500,001-1,000,000. High interest Inadequate collateral, Complicated Procedures, lack of guarantor were the major constrains encountered by the farmers in accessing loans. The study therefore recommends that Rural farmers should be encouraged to form credit and thrift cooperative societies from which they can access much cheaper credits, Moreover, to ensure that any credit obtained may be manageable for the farmers, financial institutions should provide loans with low interest rates and government and non-governmental organizations should simplify procedures associated with accessing loans.

Keywords: analysis, access, credit, farmers

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